Psychotherapy video chats may help with 'chemo brain'

A patient receives chemotherapy treatment for breast cancer at the Antoine-Lacassagne Cancer Center in Nice July 26, 2012. REUTERS/Eric Gaillard

Memory problems that plague cancer survivors after chemotherapy can sometimes be improved with a type of psychotherapy delivered by video chat, a new study suggests.

"We don't really know the prevalence, but maybe 40 to 50 percent of individuals (treated with chemotherapy) have long-term mild memory problems with verbal memory, recall of conversations, what one read," said lead author Robert Ferguson of the University of Pittsburgh Cancer Institute.

"Remembering where you parked your car or what was said in a meeting, these daily routine tasks are where failures occur," said Ferguson, who conducted the research while at the Eastern Maine Medical Center and Lafayette Family Cancer Center in Bangor, Maine.

Ferguson's team wanted to know whether a cognitive-behavioral therapy called "Memory and Attention Adaptation Training" (MAAT) would be helpful if it were delivered by video conference.

They recruited 47 Caucasian women who had completed chemotherapy for breast cancer an average of four years earlier and were still reporting memory problems. They randomly divided the women into two groups.

One group received eight 30- to 45-minute MAAT one-on-one sessions with a therapist via video conference. MAAT therapists help patients identify which types of memory loss are attributable to chemotherapy and which are not, and what types of situations increase the risk for memory lapses. They also teach stress reduction, and strategies like verbal rehearsal and visualization training to compensate for memory lapses.

The other group of women received eight video conference sessions of supportive talk therapy, with no active behavioral training.

The women completed questionnaires on memory difficulty and anxiety about memory problems and had neuropsychological tests of verbal memory and processing speed before therapy, after their eight sessions and again two months later.

At the final follow up, women who received MAAT therapy had fewer self-reported memory problems, their processing speed test results were better and they had less anxiety about memory problems than those in the comparison group.

Verbal memory was similar for both groups after treatment and at the two-month point, as reported in Cancer.

Both therapies were delivered by video conference to eliminate travel time for patients. More than half of participants said they would not have taken part if they'd had to travel or take time off from work to attend the therapy sessions, Ferguson said.

Though the MAAT program was beneficial, "we don't know (if) memory returns to pre-cancer levels," he said.

Certain rehabilitation interventions try to 'rewire the brain' to get it back to former levels of function, whereas MAAT therapy tries to tailor the intervention to the individual and identify their deficits, said Tim A. Ahles, a behavioral psychologist at Memorial Sloan Kettering Cancer Center in New York who has worked with Ferguson in the past but was not part of the new study.

"It reduces anxiety and stress, which interfere with cognitive performance, regardless of your history," Ahles told Reuters Health by phone.

Researchers have been studying chemotherapy's affect on the brain for more than 15 years, but it's still unclear why only certain people experience cognitive deficits, he said.

The current study only included white breast cancer survivors at one site, and each treatment was delivered by one clinician, Ferguson noted. Future studies should incorporate multiple sites, multiple clinicians, and cancer survivors of various ethnicities, he said.

In the meantime, physical activity is good for cognitive health, Ferguson said.